A two-galectin network establishes mesenchymal condensation phenotype in limb development

Previous work showed that Gal-1A and Gal-8, two proteins belonging to the galactoside-binding galectin family, are the earliest determinants of the patterning of the skeletal elements of embryonic chicken limbs, and further, that their experimentally determined interactions in the embryonic limb bud can be interpreted via a reaction-diffusion-adhesion (2GL: two galectin plus ligands) model. Here, we use an ordinary differential equation-based approach to analyze the intrinsic switching modality of the 2GL network and characterize the network behavior independent of the diffusive and adhesive arms of the patterning mechanism. We identify two states: where the concentrations of both the galectins are respectively, negligible, and very high. This bistable switch-like system arises via a saddle-node bifurcation from a monostable state. For the case of mass-action production terms, we provide an explicit Lyapunov function for the system, which shows that it has no periodic solutions. Our model therefore predicts that the galectin network may exist in low expression and high expression states separated in space or time, without any intermediate states. We test these predictions in experiments performed with high density cultures of chick limb mesenchymal cells and observe that cells inside precartilage protocondensations express Gal-1A at a much higher rate than those outside, for which it was negligible. The Gal-1A and -8-based patterning network is therefore sufficient to partition the mesenchymal cell population into two discrete cell states with different developmental (chondrogenic vs. non-chondrogenic) fates. When incorporated into an adhesion and diffusion-enabled framework this system can generate a spatially patterned limb skeleton.

A Field Guide to Finding Fossils on Mars

The Martian surface is cold, dry, exposed to biologically harmful radiation and apparently barren today. Nevertheless, there is clear geological evidence for warmer, wetter intervals in the past that could have supported life at or near the surface. This evidence has motivated National Aeronautics and Space Administration and European Space Agency to prioritize the search for any remains or traces of organisms from early Mars in forthcoming missions. Informed by (1) stratigraphic, mineralogical and geochemical data collected by previous and current missions, (2) Earth's fossil record, and (3) experimental studies of organic decay and preservation, we here consider whether, how, and where fossils and isotopic biosignatures could have been preserved in the depositional environments and mineralizing media thought to have been present in habitable settings on early Mars. We conclude that Noachian-Hesperian Fe-bearing clay-rich fluvio-lacustrine siliciclastic deposits, especially where enriched in silica, currently represent the most promising and best understood astropaleontological targets. Siliceous sinters would also be an excellent target, but their presence on Mars awaits confirmation. More work is needed to improve our understanding of fossil preservation in the context of other environments specific to Mars, particularly within evaporative salts and pore/fracture-filling subsurface minerals.

Experimental fossilization of mat-forming cyanobacteria in coarse-grained siliciclastic sediments

Microbial fossils and textures are commonly preserved in Ediacaran and early Cambrian coarse-grained siliciclastic sediments that were deposited in tidal and intertidal marine settings. In contrast, the fossilization of micro-organisms in similar marine environments of post-Cambrian age is less frequently reported. Thus, temporal discrepancies in microbial preservation may have resulted from the opening and closing of a unique taphonomic window during the terminal Proterozoic and early Phanerozoic, respectively. Here, we expand upon previous work to identify environmental factors which may have facilitated the preservation of cyanobacteria growing on siliciclastic sand, by experimentally determining the ability of microbial mats to trap small, suspended mineral grains, and precipitate minerals from ions in solution. We show that (i) fine grains coat the sheaths of filamentous cyanobacteria (e.g., Nodosilinea sp.) residing within the mat, after less than 1 week of cell growth under aerobic conditions, (ii) clay minerals do not coat sterile cellulose fibers and rarely coat unsheathed cyanobacterial cells (e.g., Nostoc sp.), (iii) stronger disturbances (where culture jars were agitated at 170 rpm; 3 mm orbital diameter) produce the smoothest and most extensive mineral veneers around cells, compared with those agitated at slower rotational speeds (150 and 0 rpm), and (iv) mineral veneers coating cyanobacterial cells are ~1 μm in width. These new findings suggest that sheathed filamentous cyanobacteria may be preferentially preserved under conditions of high fluid energy. We integrate these results into a mechanistic model that explains the preservation of microbial fossils and textures in Ediacaran sandstones and siltstones, and in fine-grained siliciclastic deposits that contain exceptionally preserved microbial mats.

Molecular biosignatures reveal common benthic microbial sources of organic matter in ooids and grapestones from Pigeon Cay, The Bahamas

Ooids are sedimentary grains that are distributed widely in the geologic record. Their formation is still actively debated, which limits our understanding of the significance and meaning of these grains in Earth's history. Central questions include the role played by microbes in the formation of ooids and the sources of ubiquitous organic matter within ooid cortices. To address these issues, we investigated the microbial community composition and associated lipids in modern oolitic sands at Pigeon Cay on Cat Island, The Bahamas. Surface samples were taken along a transect from the shallow, turbulent surf zone to calmer, deeper water. Grains transitioned from shiny and abraded ooids in the surf zone, to biofilm-coated ooids at about 3 m water depth. Further offshore, grapestones (cemented aggregates of ooids) dominated. Benthic diatoms and Proteobacteria dominated biofilms. Taxa that may promote carbonate precipitation were abundant, particularly those associated with sulfur cycling. Compared to the lipids associated with surface biofilms, relict lipids bound within carbonate exhibited remarkably similar profiles in all grain types. The enhanced abundance of methyl-branched fatty acids and β-hydroxy fatty acids, 1-O-monoalkyl glycerol ethers and hopanoids bound within ooid and grapestone carbonate confirms a clear association of benthic sedimentary bacteria with these grains. Lipids bound within ooid cortices also contain molecular indicators of microbial heterotrophic degradation of organic matter, possibly in locally reducing conditions. These included the loss of labile unsaturated fatty acids, enhanced long-chain fatty acids/short-chain fatty acids, enriched stable carbon isotopes ratios of fatty acids, and very high stanol/stenol ratios. To what extent some of these molecular signals are derived from later heterotrophic endolithic activity remains to be fully resolved. We speculate that some ooid carbonate forms in microbial biofilms and that early diagenetic degradation of biofilms may also play a role in early stage carbonate precipitation around ooids.

Review of evidence for dietary influences on atopic dermatitis

Atopic dermatitis (AD) is a chronic inflammatory skin disease affecting children and adolescents worldwide. The relationship of AD to diet has been a matter of curiosity for many years. Here we look at the evidence in the literature of the association between AD and diet, and the effectiveness of elimination diets and diet supplementation in the management of AD. Several studies have found an association between clinical food allergy and AD, and more recent investigations have also suggested that dietary elements may promote late AD exacerbations. Diet elimination trials in select patients who are clinically allergic to eggs have shown promise in reducing symptoms. Additionally, elimination of food additives in a subgroup of patients was found to be beneficial. Finally, diet supplementations with evening primrose oil and an omega-3 fatty acid (docosahexaenoic acid) may be appropriate in certain AD candidates.

Modeling the morphodynamic galectin patterning network of the developing avian limb skeleton

We present a mathematical model for the morphogenesis and patterning of the mesenchymal condensations that serve as primordia of the avian limb skeleton. The model is based on the experimentally established dynamics of a multiscale regulatory network consisting of two glycan-binding proteins expressed early in limb development: CG (chicken galectin)-1A, CG-8 and their counterreceptors that determine the formation, size, number and spacing of the "protocondensations" that give rise to the condensations and subsequently the cartilaginous elements that serve as the templates of the bones. The model, a system of partial differential and integro-differential equations containing a flux term to represent local adhesion gradients, is simulated in a "full" and a "reduced" form to confirm that the system has pattern-forming capabilities and to explore the nature of the patterning instability. The full model recapitulates qualitatively and quantitatively the experimental results of network perturbation and leads to new predictions, which are verified by further experimentation. The reduced model is used to demonstrate that the patterning process is inherently morphodynamic, with cell motility being intrinsic to it. Furthermore, subtle relationships between cell movement and the positive and negative interactions between the morphogens produce regular patterns without the requirement for activators and inhibitors with widely separated diffusion coefficients. The described mechanism thus represents an extension of the category of activator-inhibitor processes capable of generating biological patterns with repetitive elements beyond the morphostatic mechanisms of the Turing/Gierer-Meinhardt type.

COMPUCELL, a multi-model framework for simulation of morphogenesis

MOTIVATION

CompuCell is a multi-model software framework for simulation of the development of multicellular organisms known as morphogenesis. It models the interaction of the gene regulatory network with generic cellular mechanisms, such as cell adhesion, division, haptotaxis and chemotaxis. A combination of a state automaton with stochastic local rules and a set of differential equations, including subcellular ordinary differential equations and extracellular reaction-diffusion partial differential equations, model gene regulation. This automaton in turn controls the differentiation of the cells, and cell-cell and cell-extracellular matrix interactions that give rise to cell rearrangements and pattern formation, e.g. mesenchymal condensation. The cellular Potts model, a stochastic model that accurately reproduces cell movement and rearrangement, models cell dynamics. All these models couple in a controllable way, resulting in a powerful and flexible computational environment for morphogenesis, which allows for simultaneous incorporation of growth and spatial patterning.

RESULTS

We use CompuCell to simulate the formation of the skeletal architecture in the avian limb bud.

AVAILABILITY

Binaries and source code for Microsoft Windows, Linux and Solaris are available for download from http://sourceforge.net/projects/compucell/

Quadriceps voluntary activation at different joint angles measured by two stimulation techniques

People are able to fully activate their quadriceps at mid-length during a brief isometric contraction but it is uncertain whether this is the case at other muscle lengths. With the twitch superimposition technique for determining levels of voluntary activation (VA), the muscle may be stimulated through the intramuscular branches of the nerve or via the nerve trunk itself. The former technique is easier to use, but different populations of motor units may be stimulated if the joint position is changed to alter muscle length. The purpose of this study was to investigate quadriceps VA at a range of knee joint angles using both magnetic stimulation of the motor nerve and percutaneous electrical stimulation over the muscle belly. Eight healthy subjects (six females, mean age 29 years) performed maximal voluntary contractions of the quadriceps at knee joint angles at 10-110 degrees of flexion. Surface electromyography (EMG) of quadriceps and hamstrings was recorded as an indication of the amount of muscle activity. Nearly all subjects showed >95% VA at all joint angles. VA did not vary with joint angle nor were there significant differences between the two stimulation techniques. Similarly, there was no significant effect of knee joint angle on the EMG activity of either muscle group. These findings indicate that VA of the quadriceps during a brief isometric contraction is not affected by muscle length and can be measured by either stimulation technique.

Rates of change in measures of body size vary by ethnicity and gender

Obesity, a major risk factor for a variety of diseases, is more common in Blacks than in Whites. In the current study, a cohort of young Blacks and Whites was followed longitudinally to determine rates of change in body mass index (BMI) and subscapular and triceps skinfold thickness from the ages of 5 to 25 years. A significant difference in the rate of change of BMI (P<.0001) between Blacks and Whites was observed with Blacks gaining at a faster rate. The rate of increase of subscapular (P<.0001) and triceps fat (P<.0001) was significantly higher in the girls than in the boys. We also examined for differences by household income and maternal education level. Children from poorer families had more fat (P<.01 for all three outcomes), whereas education level was not related to the amount of body fat. Differences in the prevalence of obesity between Blacks and Whites and between males and females that manifest during adulthood appear to begin in childhood. The results re-emphasize the important need for early intervention in weight control measures.

Cranioorbital fibrous dysplasia: with emphasis on visual impairment and current surgical management

Fibrous dysplasia is a benign but slowly progressive disorder of bone in which normal cancellous bone is replaced by immature woven bone and fibrous tissue. Significant deformity and both acute and chronic visual impairment can result. A contemporary understanding of fibrous dysplasia, emphasizing the origins of visual impairment, indications for decompressive surgery, and the techniques for correction of the cosmetic deformity are presented. In their experience and review of the literature, the authors found the most frequent clinical presentations to be exophthalmos, displacement of the globe, abnormalities of extraocular motility, cosmetic deformity, and visual impairment. Although traditionally the cause of visual impairment has been ascribed to impingement of the optic canal on the optic nerve, the authors' experience is that the most common cause of visual loss is cystic degeneration of the tumor, particularly with those involving the anterior clinoid process. Exophthalmos and optic canal stenosis are less common causes of visual impairment. Indications for surgical intervention include acute and/or serially radiographically documented and relentless visual impairment and significant cosmetic deformity. Individualized management strategies are also discussed.

Abdominal muscle activity during the abdominal hollowing manoeuvre in the four point kneeling and prone positions

This study investigated the pattern of recruitment of the abdominal muscles during the abdominal hollowing manoeuvre (AHM), in four point kneeling and prone. Muscle activity was detected and recorded by surface electromyography (EMG), in 20 healthy subjects, 8 male and 12 female, aged between 19 and 30 during both maximal activity, and the AHM. The degree of activation during hollowing was expressed as a percentage of maximal. There was activity in the internal abdominal oblique (IO) during all hollowing manoeuvres, in both starting positions, whilst only two subjects showed any activity in rectus abdominis (RA). Simultaneous activity in IO and EO occurred both in four point kneeling (45% of the subjects) and especially in prone (75% of the subjects). Across both positions IO activity was significantly greater than EO. There was no significant difference in EO or IO activity comparing across positions. These results suggest that the AHM when performed in four point kneeling and prone always activates IO and rarely activates RA, whilst elimination of activity in EO is more difficult to achieve, particularly in prone. Isolated activity in the deep abdominal muscles may not always be achievable in these starting positions.

Phenotypic and dynamical transitions in model genetic networks. II. Application to the evolution of segmentation mechanisms

Knowledge of the genetic control of segmentation in Drosophila has made insect segmentation a paradigmatic case in the study of the evolution of developmental mechanisms. In Drosophila, the patterns of expression of segmentation genes are established simultaneously in all segments by a complex set of interactions between transcriptional factors that diffuse in a syncytium occupying the whole embryo. Such mechanisms cannot act in short germ-band insects where segments appear sequentially from a cellularized posterior proliferative zone. Here, we compare mechanisms of segmentation in different organisms and discuss how the transition between the different types of segmentation can be explained by small and progressive changes in the underlying gene networks. The recent discovery of a temporal oscillation in expression during somitogenesis of vertebrate homologs of the pair-rule gene hairy enhances the plausibility of an earlier proposal that the evolutionary origin of both the short- and long germ-band modes of segmentation was an oscillatory genetic network (Newman 1993). An implication of this scenario is that the self-organizing, pattern-forming system embodied in an oscillatory network operating in the context of a syncytium (i.e., a reaction-diffusion system)-which is hypothesized to have originated the simultaneous mode of segmentation-must have been replaced by the genetic hierarchy seen in modern-day Drosophila over the course of evolution. As demonstrated by the simulations in the accompanying article, the tendency for "emergent" genetic networks, associated with self-organizing processes, to be replaced through natural selection with hierarchical networks is discussed in relation to the evolution of segmentation.

Phenotypic and dynamical transitions in model genetic networks. I. Emergence of patterns and genotype-phenotype relationships

Genotype-phenotype interactions during the evolution of form in multicellular organisms is a complex problem but one that can be aided by computational approaches. We present here a framework within which developmental patterns and their underlying genetic networks can be simulated. Gene networks were chosen to reflect realistic regulatory circuits, including positive and negative feedback control, and the exchange of a subset of gene products between cells, or within a syncytium. Some of these networks generate stable spatial patterns of a subset of their molecular constituents, and can be assigned to categories (e.g., "emergent" or "hierarchic") based on the topology of molecular circuitry. These categories roughly correspond to what has been discussed in the literature as "self-organizing" and "programmed" processes of development. The capability of such networks to form patterns of repeating stripes was studied in network ensembles in which parameters of gene-gene interaction were caused to vary in a manner analogous to genetic mutation. The evolution under mutational change of individual representative networks of each category was also simulated. We have found that patterns with few stripes (< or =3) are most likely to originate in the form of a hierarchic network, whereas those with greater numbers of stripes (> or =4) originate most readily as emergent networks. However, regardless of how many stripes it contains, once a pattern is established, there appears to be an evolutionary tendency for emergent mechanisms to be replaced by hierarchic mechanisms. These results have potential significance for the understanding of genotype-phenotype relationships in the evolution of metazoan form.

Environmental effects on the fatty acid composition of subcutaneous beef fat

This paper describes the effect of location and level of nutrition before finishing on the fatty acid composition of subcutaneous beef fat. Interactions between location and nutritional treatments, finishing regime and market category were also examined. The effect of level of nutrition on the fatty acid composition of beef fat during the period from weaning until feedlot entry was small but significant. The lowest level of nutrition had the highest percentage of C18:0 at slaughter, which was offset by reductions in C16:0 in cohort 93-1 and C18:1c9 in cohort 94-2. Location had a large effect on the fatty acid composition of subcutaneous beef fat. At a common slaughter weight, cattle grown in a tropical environment were older, fatter and had higher percentages of saturated fats, including C16:0 and C18:0, than cattle grown out in a temperate environment.

Epigenetic mechanisms of character origination

The close mapping between genotype and morphological phenotype in many contemporary metazoans has led to the general notion that the evolution of organismal form is a direct consequence of evolving genetic programs. In contrast to this view, we propose that the present relationship between genes and form is a highly derived condition, a product of evolution rather than its precondition. Prior to the biochemical canalization of developmental pathways, and the stabilization of phenotypes, interaction of multicellular organisms with their physicochemical environments dictated a many-to-many mapping between genomes and forms. These forms would have been generated by epigenetic mechanisms: initially physical processes characteristic of condensed, chemically active materials, and later conditional, inductive interactions among the organism's constituent tissues. This concept, that epigenetic mechanisms are the generative agents of morphological character origination, helps to explain findings that are difficult to reconcile with the standard neo-Darwinian model, e.g., the burst of body plans in the early Cambrian, the origins of morphological innovation, homology, and rapid change of form. Our concept entails a new interpretation of the relationship between genes and biological form.

Stages of improvement in visual fields after pituitary tumor resection

PURPOSE

To use static threshold perimetry to examine the stages of improvement and the potential for late improvement of visual fields after surgical resection of pituitary adenomas causing visual loss from compression of the anterior visual pathways.

METHODS

Retrospective review of charts of patients with pituitary tumors and abnormal static threshold perimetry before or soon after treatment who had subsequent visual fields. Quantification of the visual field mean deviation overall, superotemporally, and inferotemporally was performed and compared between visits. Postoperative visits were considered in five time periods: visit 1 (surgery to 1 week), visit 2 (1 month to 4 months), visit 3 (6 months to 1 year), visit 4 (2 years), and visit 5 (3 or more years).

RESULTS

Sixty-two patients were included (33 men and 29 women; mean age 54 years [SD +/- 15 years; range, 22 to 83 years]). At visit 1, the relative improvement of the overall mean deviation for the right eye was 30.8% (P =.01) and for the left eye was 13.7% (P =.3067). At visit 2, the relative improvement of the overall mean deviation for the right eye was 30. 4% (P =.0142) and for the left eye was 32.6% (P =.0092). At visits 1 and 2, the inferotemporal quadrants were the quadrants with greatest improvement (visit 1, right eye, 37.8% [P =.0082]; visit 2, left eye, 30.8% [P =.0074]). At visits 3, 4, and 5, an overall trend toward mild improvement was observed with statistical significance only for the inferotemporal quadrant of the left eye from visit 2 to visit 3, which improved 19.7% (P =.0270).

CONCLUSION

The pattern of recovery of visual function after decompression of the anterior visual pathways suggests at least three phases of improvement. The early fast phase (surgery to 1 week) of improvement may lead to normalization of visual fields in some individuals. The early slow phase (1 month to 4 months) is the period of most notable improvement. A late phase (6 months to 3 years) of mild improvement does not appear significant overall but may be marked in some individuals. Each of these phases may have one or more mechanisms underlying the observed improvement.

Heart rate as a predictor of future blood pressure in schoolchildren

Heart rate (HR) has been shown to predict future blood pressures (BP) in studies in adults. We explored the relation of HR to future BP levels in a cohort of 344 black and 456 white schoolchildren ages 5 to 19 years, to examine the hypothesis that HR predicts subsequent BP even very early in life. After making baseline measurements, BP was assessed longitudinally 1 to 24 additional times (mean = 8.25) after the baseline period, at intervals of approximately 6 months. We found that HR was significantly related to future diastolic BP in the black boys (P = .016) after adjusting for baseline diastolic BP, age, and body mass index, but not in the black girls or in the white children. Because HR is reflective of sympathetic nervous system (SNS) activity that in turn can be related to the renin-angiotensin system (RAS), we also explored the relation of HR to the RAS by studying relationships to variants in the angiotensinogen gene and the angiotensin I-converting enzyme (ACE) gene. We found a significantly positive relationship of HR to the presence of the deletion allele of the ACE gene (P = .0015), but, again, only in the black boys. Because blacks in general appear to retain additional sodium when compared with whites, the SNS, as reflected in the HR, may influence BP more when individuals have increased sodium retention. In summary, baseline HR predicted future diastolic BP in the black boys but not in the black girls or in the white children.

The cavernous sinus

The parasellar region, in particular the cavernous sinus, represents the confluence of critical structures involved in both the afferent and efferent visual pathways. It is not surprising that lesions affecting the area of the cavernous sinus most frequently present with neuro-ophthalmic complaints, which include double vision, decreased vision, pain, and numbness. Neuro-surgical intervention in the area of hte cavernous sinus often produces neuro-ophthalmic complications. A rehabilitative effort directed to the neuro-ophthalmic manifestations is essential for patients with skull-base pathology.

Levels of mineralocorticoids in whites and blacks

Blacks appear, on average, to retain more Na than whites. A higher production rate of mineralocorticoids could explain the greater Na retention in blacks. Although production of aldosterone has been shown to be lower in blacks, the level of another mineralocorticoid may be increased. Plasma levels of deoxycorticosterone and cortisol were measured in young whites (n=23; age=16.4+/-3.1[SD] years) and young blacks (n=25; age=13.8+/-1.3 years). Blacks had lower plasma levels of renin activity and aldosterone and lower urinary aldosterone excretion rates; thus, they appeared to be representative of blacks that retain additional Na. Plasma deoxycorticosterone levels were lower in blacks than in whites both at baseline (247+/-161 versus 381+/-270 pmol/L, P=0.048) and after stimulation with adrenocorticotropic hormone (822+/-294 versus 1127+/-628 pmol/L at 30 minutes, P=0.047; 925+/-366 versus 1440+/-834 pmol/L at 60 minutes, P=0.013). Cortisol levels were also lower in blacks at baseline (P=0.014) but were not significantly different from levels in whites after stimulation with adrenocorticotropic hormone. In a larger cohort of 407 whites (age=12.0+/-2.9 years) and 247 blacks (age=12.9+/-3.1 years), 18-hydroxycortisol excretion rates were also lower in blacks (P=0. 021). In conclusion, increased Na retention in blacks does not appear to be secondary to increased production of either aldosterone, deoxycorticosterone, cortisol, or 18-hydroxycortisol. A primary renal mechanism may mediate the increase in Na reabsorption in blacks.

Generation, integration, autonomy: three steps in the evolution of homology

The homology concept harbours implicit assumptions about the evolution of morphological organization. Homologues are natural units in the construction of organismal body plans. Their origin and maintenance should represent a key element of a comprehensive theory of morphological evolution. Therefore, it is necessary to understand the causation of homology and to investigate the mechanisms underlying its origination. The study of this issue cannot be limited to the molecular level, because there appears to exist no strict correspondence between genetic and morphological evolution. It is argued that the establishment of homology follows three distinct (if overlapping) steps: (a) the generation of morphological building elements; (b) the integration of new elements into a body plan; and (c) the autonomization of integrated construction units as lineage-specific homologues of phenotypic evolution. In contrast with traditional views, it is proposed that the mechanistic basis for steps (a) and (b) is largely epigenetic, i.e. a consequence of the inherent propensities of developmental system under changing conditions. Step (c) transcends the proximate mechanisms underlying the establishment of homologues and makes them independent attractors of morphological organization at the phenotypic level.

The role of preoperative adjuvant treatment in the management of esthesioneuroblastoma: the University of Virginia experience

OBJECTIVE

Multidisciplinary management of esthesioneuroblastoma has effected markedly increased survival during the past 20 years. The potential for radical craniofacial surgery for complete en bloc resection, the availability of advanced neuroimaging modalities, and the incorporation of neoadjuvant therapy into treatment strategies for tumor remission have all contributed to this accomplishment. However, a standard protocol for the management of these lesions has not been accepted; preoperative radiation and chemotherapy have been advocated, but neither radiographic nor clinical response has been quantified.

METHODS

Thirty-four consecutive patients with biopsy-proven esthesioneuroblastoma treated at one institution from 1976 to 1994 were reviewed to determine the effects of preoperative radiation therapy, with or without chemotherapy, on tumor size and long-term survival.

RESULTS

In a multivariate regression analysis, advanced age was predictive of decreased disease-free survival (P=0.008), whereas advanced Kadish stage was associated with a borderline higher rate of disease-related mortality (P=0.056). Two-thirds of the patients showed a significant reduction in tumor burden with adjuvant therapy. Patients with response to neoadjuvant therapy demonstrated a significantly lower rate of disease-related mortality (P=0.050). In this series, the overall 5- and 10-year survival rates were 81.0 and 54.5%, respectively.

CONCLUSION

Preoperative neoadjuvant therapy provides a valuable complement to radical craniofacial resection, leading to reduction in tumor burden. Patients experiencing reduction in tumor volume by neoadjuvant therapy demonstrate an improved prognosis.

Interaction of the NH2-terminal domain of fibronectin with heparin. Role of the omega-loops of the type I modules

Determinants of the interaction of the 29-kDa NH2-terminal domain of fibronectin with heparin were explored by analysis of normal and mutant recombinant NH2-terminal fibronectin fragments produced in an insect cell Baculovirus host vector system. A genomic/cDNA clone was constructed that specified a secretable human fibronectin NH2 fragment. With the use of site-directed mutagenesis a set of 29 kDa fragments was obtained that contained glycine or glutamic acid residues in place of basic residues at various candidate sites for heparin binding in the five type I modules that make up the domain. The recombinant fragment containing the wild type sequence had a nearly normal circular dichroic spectra and a melting profile, as assayed by loss of ellipticity at 228 nm, that was indistinguishable from that of the native fragment obtained by trypsinization of plasma fibronectin. A substantial proportion of the wild type recombinant fragment bound to heparin-Sepharose, where it was eluted at the same NaCl concentration as the native fragment. The wild type fragment was capable of promoting matrix-driven translocation, a morphogenetic effect in artificial extracellular matrices that depends on the interaction of the fibronectin NH2 terminus with heparin-like molecules on the surfaces of particles. Mutant fragments in which arginines predicted to be most exposed in the folded fragment were converted to glycines retained the same affinity for heparin as the wild type fragment. In contrast, a mutant fragment in which the single basic residue (Arg99) in the minor loop ("Omega-loop") of the second type I module was converted to a glycine had an essentially normal melting profile but exhibited no binding to heparin and failed to promote matrix-driven translocation. A mutant fragment in which the single basic residue (Arg52) of the first type I module was converted to a glycine also completely lacked heparin binding activity, but one in which the single basic residue (Arg191) the fourth type I module was converted to a glycine retained the ability to bind heparin. A mutant fragment in which the single basic residue (Lys143) in the Omega-loop of the third type I module was converted to a glutamic acid lacked heparin binding activity but had a CD spectrum similar to the heparin-liganded native protein and was capable of promoting matrix-driven translocation. The results indicate that multiple residues in the Omega-loops of the fibronectin NH2-terminal domain participate in its interactions with heparin. In addition, the conformation of one of the nonbinding mutants may mimic the heparin-induced structural alteration in this fibronectin domain required for certain morphogenetic events.

Nuclear localization of type II cAMP-dependent protein kinase during limb cartilage differentiation is associated with a novel developmentally regulated A-kinase anchoring protein

Differentiation of chicken limb cartilage is accompanied by a rise in intracellular cyclic AMP, an inducer of cartilage-specific gene expression. A basic approximately 35-kDa protein, designated p35, is the major nuclear substrate for cAMP-dependent protein kinase (PKA) during this process. Here we show that whereas both precartilage and cartilage nuclei contain p35, only precartilage nuclei contain PKA. The phosphorylation of p35 in isolated cell fractions was used as an index of changes in the cellular compartmentalization of components of PKA during chondrogenesis. Both the catalytic subunit and type II regulatory subunit (RII) of PKA were present in the precartilage nuclear fraction, but were undetectable or present in only trace amounts in the cartilage nuclear fraction. Furthermore, a novel approximately 150-kDa A-kinase anchoring protein (AKAP), which binds to RII, was detected in the nuclear matrix of precartilage nuclei but, like RII, was virtually absent in the nuclei of fully differentiated cartilage cells. In limb mesenchymal cells undergoing chondrogenesis in culture a corresponding set of changes occurred: cartilage differentiation was accompanied by a marked reduction in the amounts of both nuclear RII and nAKAP150. These observations indicate that type II PKA holoenzyme is imported into the mesenchymal cell nucleus prior to chondrogenesis, an event that appears to depend on the activity of the developmentally regulated nAKAP150.

Sticky fingers: Hox genes and cell adhesion in vertebrate limb development

During vertebrate limb development, various genes of the Hox family, the products of which influence skeletal element identity, are expressed in specific spatiotemporal patterns in the limb bud mesenchyme. At the same time, the cells also exhibit 'self-organizing' behavior--interacting with each other via extracellular matrix and cell-cell adhesive molecules to form the arrays of mesenchymal condensations that lead to the cartilaginous skeletal primordia. A recent study by Yokouchi et al. establishes a connection between these phenomena. They misexpressed the product of the Hoxa-13 gene in chick limb buds and demonstrated both skeletal pattern perturbations and changes in cell-cell adhesivity in mesenchyme aberrantly expressing this protein.

Prevention and management of complications associated with the hydroxyapatite implant

The hydroxyapatite orbital implant offers many advantages compared to conventional implants; however, its use is not entirely free of complications. The objectives of this study are to review the complications encountered with the hydroxyapatite orbital implant, suggest mechanisms contributing to the development of these complications, and emphasize aspects of surgical technique that will minimize the risk of the most frequent complication, implant exposure. Preoperative, operative, and postoperative records of 154 patients receiving primary and secondary hydroxyapatite implants were studied retrospectively. Three clinical types of exposure defects were observed; dehiscences along the horizontal suture line, defects over holes in the hydroxyapatite, and a defect adjacent to the site of radiation plaque therapy. Most small exposures healed spontaneously. Medium and large defects were associated with anteriorly malpositioned implants, most often required surgical intervention, and were successfully managed with one or a combination of techniques including flaps, mucous membrane grafts, or repositioning of the implant more posteriorly. Placing the hydroxyapatite implant as far posteriorly as possible and advancing the extraocular muscles 3-5 mm from the apex of the implant will prevent most exposures. Unlike other types of implants, the hydroxyapatite implant does not migrate or extrude, and when exposed, usually does not require removal.

Different roles for fibronectin in the generation of fore and hind limb precartilage condensations

Fibronectin expression and spatiotemporal distribution were examined in relation to the distinctive patterns of mesenchymal condensation and chondrogenesis seen in high-density serum-free cultures of chicken wing and leg bud precartilage cells. More fibronectin protein was produced on a per cell basis by leg than by wing mesenchyme, both in freshly isolated tissue and during the prechondrogenic condensation period in culture, where the difference was twofold. The quantitative difference in fibronectin expression in freshly isolated wing and leg mesenchyme was also seen at the level of total and poly (A)+ RNA. During the condensation phase, fibronectin was distributed in the wing and leg mesenchymal cultures in a way that prefigured the eventual distribution of cartilage in these cultures: in wing cultures condensations were broad and flat, and rich in diffusely organized fibronectin; in leg cultures, condensations were compact and spheroidal, and contained abundant deposits of fibronectin. In addition, the leg condensations were connected by long fibronectin-rich fibers. Transient treatment with TGF-beta early during the culture period led to increase in fibronectin production and expansion of condensations in both wing and leg cultures. Leg mesenchyme was more responsive to transforming growth factor-beta than wing mesenchyme with respect to fibronectin production, and this was reflected in a greater enhancement of cartilage formation in later cultures. Treatment of cultures with monoclonal antibody 304 directed against the amino-terminal heparin-binding domain of fibronectin inhibited condensation formation and reduced chondrogenesis in wing mesenchyme, but left these two processes unchanged in leg mesenchyme, despite disruption by the antibody of the leg-specific fibronectin fibers. These studies indicate that for both wing and leg mesenchyme the morphology, extent, and spatiotemporal regulation of precartilage condensation and subsequent chondrogenesis closely parallels the deposition of fibronectin. But whereas the interaction between cells and fibronectin in wing bud mesenchyme is mediated in part by the protein's amino-terminal domain, this domain does not appear to be involved in analogous interactions in leg bud mesenchyme.

Vascular disease

This last year has been a particularly busy one in the field of neuro-ophthalmology. The publication of the second, important, randomized multicentered trial in neuro-ophthalmology highlights the power of randomized trials to answer important clinical questions. This and other publications emphasize the pivotal role of vascular pathophysiology in production of neuro-ophthalmic disease. The progress in our understanding of mechanisms of vascular obstruction, risk factors for vascular disease and ocular manifestations, as well as technical advances in our approach to patients with vascular problems have continued the broad-front advancement in neuro-ophthalmology.

A phase 1-2 trial of superselective carboplatin, low-dose infusional 5-fluorouracil and concurrent radiation for high-grade gliomas

Recent trials have suggested that low-dose infusional 5-FU is more efficacious when given during radiotherapy than is bolus 5-FU. Additionally, intra-arterial cisplatin for brain tumors has been shown to be associated with both high response rates as well as significant toxicity. A dose escalation study was therefore performed using superselective carboplatin, a cisplatin analogue with a favorable CNS toxicity profile in combination with 6 weeks of infusional 5-FU at 225 mg/m2 and concurrent radiotherapy. Eight patients were treated at the starting dose of 200 mg/m2 carboplatin and 11 patients were treated at 300 mg/m2. No toxicity was observed that was attributable to infusional 5-FU. However, two ischemic events related to the superselective delivery of carboplatin were observed, and one patient was noted to have asymptomatic retinal toxicity from the carboplatin. Of 19 patients, 5 had objective responses with 25% or greater reduction in tumor volumes. Continuous infusional 5-FU can be given in combination with partial brain radiotherapy without significant toxicity. Superselective carboplatin delivery is associated with a low incidence of stroke, but no significant retinal toxicity.

Papaverine-induced mydriasis

Five cases of ipsilateral pupillary dilatation that developed during local intraarterial infusion of papaverine are reported. All patients were being treated for symptomatic vasospasm secondary to subarachnoid hemorrhage. In each case, the tip of the infusion catheter was positioned in the internal carotid artery in close proximity to the ostium of the ophthalmic artery. Pupillary dilatation in all patients readily resolved after termination of the infusion.

Morphogenetic differences between fore and hind limb precartilage mesenchyme: relation to mechanisms of skeletal pattern formation

Using a serum-free culture system, we have investigated morphogenetic differences between fore and hind limb precartilage mesenchymal cells derived from stages 21-26 chicken embryos. Across all stages, wing and leg cultures were intrinsically different in the amount and spatial organization of cartilage that they produced. By stage 24, leg cells began to produce a nodular pattern of cartilage while wing cells continued to produce sheets of cartilage. This pattern difference persisted throughout the later stages and was not due to differences in cell survival as judged by DNA content or to the presence of distinctive cell subpopulations in either tissue, as determined by flow cytometry. Chondrogenesis in wing and leg precartilage cell cultures was affected differently by 10% fetal bovine serum, TGF-beta 1 (1 ng/ml for 5 hr on the day after plating), and retinoic acid (5 ng/ml). In wing cultures, the extent of chondrogenesis was significantly enhanced by serum or by a combination of TGF-beta 1 and retinoic acid, but the cartilage pattern was not altered with any treatment. In leg cultures, the extent of chondrogenesis was enhanced by TGF-beta 1 alone, inhibited by retinoic acid alone, and the cartilage pattern was changed from nodular to sheet-like by treatment with TGF-beta 1. Wing and leg cultures also differed from each other in relative cohesivity and in condensation morphology and organization of fibronectin during the early phase of differentiation. Wing cells produced broad, flat condensations containing diffusely organized fibronectin, whereas leg cells elaborated an extensive network of long fibronectin-rich fibrils connecting very compact, fibronectin-rich condensations. These intrinsic and induced differences in fore and hind limb mesenchyme provide insight into the mechanisms that are common to the formation of all limb skeletal elements and those that distinguish skeletal elements from different limb regions and limb types.